With the emerging trend of aesthetic medical therapy, several modalities have been developed to further the drive for human self-preservation. Cosmetic and oculoplastic surgery have increasingly crossed paths in the pursuit of noninvasive procedures with which to rejuvenate human skin, mostly facial skin. One of the recent innovations in oculofacial surgery involves the use of nonablative laser and light sources to reduce the appearance of facial creases. However, disadvantages of laser-based treatments include the necessity for multiple treatments and results that may regress or have unpredictable results. Moreover, the efficacy of such systems done on cases with severe skin laxity does not appear satisfactory in some patients.
Recent advances in management of flaccid skin disorders have led to the development of radiofrequency treatments. Several devices have been developed to deliver radiofrequency energy in a non-ablative fashion that generates heat through resistance in the dermis and subcutaneous tissue to improve facial rhytides and skin laxity.
A typical method of using electrosurgery to remove facial lesions was to shave them with loop shaped electrodes. The surgeon needed to use a great deal of skill to avoid creating a deep divot into the skin below the lesion borders. Putting pressure on the handpiece holding the loop electrode tended to produce a divot that was very difficult to heal and often created scarring, delayed healing and excess pain as a result of going too deep into the tissue. A major disadvantage as a result was that the learning curve to master the cosmetic procedure of removing facial and all skin blemishes with a loop electrode was long.
Other typical methods of removing superficial lesions are scalpels, curettes, electrosurgery devices, cryosurgery methods, and lasers. Scalpels cut or incise out the lesion. Curettes scrape out the lesion in divots. Electrosurgery burns the lesion out. Cryosurgery freezes in depth. Lasers burn the lesion out. While the aim in superficial lesion removal, especially in the facial areas, should be to do so with the least amount of consequent tissue destruction, excessive tissue trauma (necrosis of tissues) will tend to result in increased fibrosis with any of the above surgical tools. The greater the penetration into the skin from the trauma-causing-modality, the more likely it is that scarring will result. Scarring is unacceptable when it occurs after treatment of very superficial skin lesions of a cosmetic nature.